Evaluation of the efficiency of a new hollow fiber plasmapheresis filter

Plasma separation for plasma exchange or plasma treatment has, until now, been obtained prevalently by centrifugal separators. Recently, filters capable of continuously separating the plasma have been proposed. We have evaluated, both in vivo and ex vivo, the efficiency of a plasma separating filter (BT 900, Dideco, Mirandola, Italy) incorporating polypropylene hollow fibers with a pore size of 0.55 micron (PS 510 W, Membrana, Wuppertal, Germany) and an effective surface of 0.23 m2, using two hemodialysis blood pumps. Ex vivo, (bovine blood) at a blood flow (QB) of 100 ml/min, 47 +/- 2.8 ml/min of plasma were obtained in the first hour and 34 +/- 3.1 ml/min in the second hour. The Sieving coefficient was 100 for albumin and IgG, 98.4 for IgA and 92.3 for IgM. Neither hemolysis nor platelet contamination were observed. In vivo, 35 treatment were performer on 19 patients affected with mixed essential cryoglobulinemia, autoimmune glomerulonephritis, Wegener disease, thrombotic thrombocytopenic microangiopathy and rheumatoid arthritis. There were no clinical complications and the treatment was always well tolerated. A mean of 2064 +/- 400 ml of plasma was obtained in 103.7 +/- 29 minutes. The plasma flow was correlated (p less than 0.001) with the blood flow (13.4 ml/min at QB = 30 ml/min; 29 ml/min at QB = 100 ml/min). In some cases, immune complexes were found in the plasma removed by the filter (conglutinin method), confirming the membrane permeability to these high weight molecules. The use of hollow fibers to separate formed elements of blood from plasma has a brief history (1, 5).(ABSTRACT TRUNCATED AT 250 WORDS)